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Cytokeratins and lung carcinomas.

N V Nhung1, P Mirejovský, T Mirejovský

  • 1Hlava Institute of Pathology, 1st Medical Faculty, Charles University, Prague.

Ceskoslovenska Patologie
|October 20, 2000
PubMed
Summary

Cytokeratin (CK) expression aids in differentiating lung adenocarcinoma from squamous cell carcinoma. CK7, CK10/13, and CK18 show distinct patterns, while CK19 is common in both, and CK20 is rare.

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Area of Science:

  • Oncology
  • Pathology
  • Molecular Biology

Background:

  • Cytokeratins (CK) are increasingly utilized as tumor markers in various carcinomas.
  • Their role in lung cancer diagnosis, including distinguishing primary from secondary tumors, histological typing, and prognosis, is under investigation.
  • Previous studies yielded inconclusive results, necessitating further research.

Purpose of the Study:

  • To investigate the expression of cytokeratins (CK7, CK10/13, CK18, CK19, CK20) in lung cancer.
  • To analyze cytokeratin immunophenotypes in relation to histological characteristics, TNM stages, and patient survival.
  • To determine the utility of these CKs in differentiating lung carcinoma subtypes.

Main Methods:

  • Analysis of 72 surgically resected lung specimens: 31 adenocarcinomas, 30 squamous cell carcinomas, and 11 neuroendocrine carcinomas.
  • Immunohistochemical staining for CK7, CK10/13, CK18, CK19, and CK20.
  • Comparison of cytokeratin expression patterns with tumor histology, TNM staging, and patient survival data.

Main Results:

  • CK7, CK10/13, and CK18 effectively distinguish lung adenocarcinomas (CK7+, CK10/13-, CK18+) from squamous cell carcinomas (CK7-, CK10/13+, CK18-).
  • CK19 showed high expression in both adenocarcinoma (90.3%) and squamous cell carcinoma (86.7%), while CK20 expression was low (9.7% and 3.3%, respectively).
  • Neuroendocrine tumors were generally non-reactive, except for abundant CK18 expression in carcinoid tumors. Prognostic significance of CK7 and CK18 in squamous cell carcinoma was suggested but not confirmed.

Conclusions:

  • Specific cytokeratin profiles (CK7, CK10/13, CK18) are valuable for differentiating lung adenocarcinoma from squamous cell carcinoma.
  • CK19 is a common marker for both major lung cancer types, whereas CK20 is rare.
  • CK18 is expressed in neuroendocrine tumors, particularly carcinoids, aiding in their identification.

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